Prognostic value of the Kyoto Prognostic Index in higher-risk diffuse large B-cell lymphomas treated by upfront autologous stem cell transplantation in JCOG0908 trial

Kobayashi, Tsutomu ¹Yamamoto, Kazuhito ²Kagami, Yoshitoyo ³Machida, Ryunosuke ⁴Miyazaki, Kana ⁵Nakamura, Shigeo ⁶Kuroda, Junya ¹Maruyama, Dai ⁷Nagai, Hirokazu⁸

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作者信息

1. Grad Sch Med Sci,Kyoto Prefectural Univ Med
2. Dept Hematol & Cell Therapy,Aichi Canc Ctr
3. Dept Hematol,Toyota Kosei Hosp
4. JCOG Data Ctr,Natl Canc Ctr
5. Dept Hematol & Oncol,Mie Univ
6. Dept Pathol,Nagoya Univ
7. Dept Hematol & Oncol,Japanese Fdn Canc Res
8. Dept Hematol,Natl Hosp Org
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Abstract

Background: There is currently no standard prognostic model optimized for the patients with diffuse large B-cell lymphoma (DLBCL) treated with upfront intensive immunochemotherapy including autologous stem cell transplantation (ASCT). The Kyoto Prognostic Index (KPI) has been proposed as a novel prognostic model for DLBCL, which can accurately identify especially high-risk patients. In this study, we investigated the prognostic value of the KPI in JCOG0908 trial in which higher-risk DLBCL patients defined by the conventional International Prognostic Index (IPI) were treated with upfront high dose therapy followed by ASCT. Methods: Fifty-eight patients with DLBCL, not otherwise specified, enrolled in JCOG0908 and confirmed by the central pathological review were analyzed. The Kaplan-Meier method was used to estimate the probabilities of overall survival (OS) and progression-free survival (PFS). We compared the discrimination ability of the KPI with that of the IPI. Results: According to KPI, 3-year OS and PFS rates were 86.7% and 76.7% in low-intermediate, 73.3% and 60.0% in high-intermediate, and 61.5% and 46.2% in high-risk group. According to IPI, 3-year OS and PFS rates were 75.0% and 50.0% in low-intermediate, 82.9% and 74.3% in high-intermediate, and 63.6% and 54.5% in high-risk group. The concordance-indices of KPI and IPI were 0.642 and 0.580 for OS and 0.606 and 0.606 for PFS. Conclusions: The KPI may be a suitable predictor of outcome than the IPI for patients with higher-risk DLBCL treated with upfront intensive immunochemotherapy including ASCT.

Key words

diffuse large B-cell lymphoma/International Prognostic Index/Kyoto Prognostic Index/autologous stem cell transplantation/CHEMOTHERAPY PLUS RITUXIMAB/INFLAMMATION/SURVIVAL/CHOP/IPI

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出版年

2022

Japanese journal of clinical oncology.

ISSN：0368-2811

被引量1

参考文献量18

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